The cost‐effectiveness of three types of worksite wellness programs for reducing the cardiovascular disease risk factors of employees was examined at three manufacturing plants in terms of their incremental costs and effectiveness over a comparison site that used a simpler and cheaper program design. The risks targeted were hypertension, obesity, cigarette smoking, and lack of regular physical exercise. The annual direct cost per employee for post‐screening interventions was $17.68 for Site A (the comparison site that offered health education classes), $39.28 for Site B (physical fitness facility), $30.96 for Site C (health education plus follow‐up counseling), and $38.57 for Site D (health education, follow‐up counseling, plus plant organization for health promotion). The addition of a physical fitness facility (Site B) did not produce any incremental benefit in reducing risks, as compared with health education classes (Site A), and Site B showed the lowest percentage of employees exercising regularly at the end of the 3‐year study period. In contrast, the sites that used systematic outreach and follow‐up counseling (Sites C and D) were more effective than both

The program models that offered short-term interventions promoted through local media suffered in comparison with models that included personal outreach to people at risk, a variety of health improvement intervention modalities, and ongoing follow-up counseling to help people make decisions and sustain health improvements.

Objectives A major hurdle in osteoarthritis (OA) research is the lack of sensitive detection and monitoring methods. It is hypothesized that proteases, such as matrix metalloproteinases (MMPs), are upregulated at early stages of OA development. The aim of this study was to investigate if a near infrared fluorescence (NIRF) probe activated by MMPs could visualize in vivo OA progression starting from its early stages. Methods Using an MMP activatable NIRF probe (MMPSense680), we assessed the upregulation of MMP activity in vitro by incubating human chondrocytes with the pro-inflammatory cytokine IL-1β. MMP activity was then evaluated in vivo serially in a chronic, injury-induced OA mouse model. For tracking MMP activity over time, mice were imaged 1 – 8 weeks post OA inducing surgery. Imaging results were correlated with histology. Results In vitro studies confirmed that NIRF imaging could identify enhanced MMP activity in IL-1β-treated human chondrocytes. In vivo imaging showed significantly higher fluorescent intensity in OA knees compared to sham knees (control) of the same mice. Additionally, the total emitted fluorescence intensity steadily increased over the entire course of OA progression that was examined. NIRF imaging results correlated with histological analysis, which showed an increase in articular cartilage structural damage over time. Conclusions Imaging of MMP activity in an OA mouse model provided sensitive and consistent visualization of OA progression, beginning from the early stages of OA. In addition to facilitating the preclinical study of OA modulators, this approach has the potential for future human translation.

Osteoarthritis (OA) is a widespread chronic joint disease characterized by articular cartilage destruction and accompanied by pain and disability. In this study, we found that the expression of Insulin-like Growth Factor II (IGF-II) was reduced in articular cartilage in human OA patients as well as in the murine experimental OA model of destabilization of the medial meniscus (DMM). In primary human articular chondrocytes, ectopic expression of lentiviral IGF-II inhibited pro-inflammatory cytokine IL-1β-induced NF-κB activation as well as catabolic gene expression. Interestingly, IGF-II did not significantly alter the phosphorylation states of ERK1/2 or Akt, which are kinases typically activated by IGF-I. Instead, it induced the activity of phospholipase C (PLC) and a PLC inhibitor blocked the inhibitory activity of IGF-II against IL-1β, suggesting that this activity is mediated through PLC. Furthermore, IGF-II increased cartilage matrix levels and decreased MMP13 protein expression in explanted human OA cartilage cultures in vitro. In the in vivo DMM model, intraarticular injection of lentiviral IGF-II led to enhanced cartilage matrix levels and decreased MMP13 protein expression, as well as reduced osteophyte formation and subchondral bone sclerosis. Therefore, our results suggest that IGF-II can promote cartilage integrity and halt knee joint destruction in OA.

Microbial biofilms are ubiquitous in drinking water systems, yet our understanding of drinking water biofilms lags behind our understanding of those in other environments. Here, a six-member model bacterial community was used to identify the interactions and individual contributions of each species to community biofilm formation. These bacteria were isolated from the International Space Station potable water system and include Cupriavidus metallidurans , Chryseobacterium gleum , Ralstonia insidiosa, Ralstonia pickettii, Methylorubrum (Methylobacterium) populi and Sphingomonas paucimobilis , but all six species are common members of terrestrial potable water systems. Using reconstituted assemblages, from pairs to all 6 members, community biofilm formation was observed to be robust to the absence of any single species and only removal of the C. gleum / S. paucimobilis pair, out of all 15 possible 2-species subtractions, led to loss of community biofilm formation. In conjunction with these findings, dual-species biofilm formation assays supported the view that the contribution of C. gleum to community biofilm formation was dependent on synergistic biofilm formation with either R. insidiosa or C. metallidurans . These data support a model of multiple, partially redundant species interactions to generate robustness in biofilm formation. A bacteriophage and multiple predatory bacteria were used to test the resilience of the community to the removal of individual members in situ, but the combination of precise and substantial depletion of a single target species was not achievable. We propose that this assemblage can be used as a tractable model to understand the molecular bases of the interactions described here and to decipher other functions of drinking water biofilms.

Wnt7a is a protein that plays a critical role in skeletal development. However, its effect on cartilage homeostasis under pathological conditions is not known. In this study, we found a unique inverse correlation between Wnt7a gene expression and that of MMP and IL-1β in individual human OA cartilage specimens. Upon ectopic expression in primary human articular chondrocytes, Wnt7a inhibited IL-1β-induced MMP and iNOS gene expression. Western blot analysis indicated that Wnt7a induced both canonical Wnt signaling and NFAT and Akt non-canonical signaling. Interestingly, inhibiting the canonical and Akt pathway did not affect Wnt7a activity. However, inhibiting the NFAT pathway impaired Wnt7a’s ability to inhibit MMP expression, suggesting that Wnt7a requires NFAT signaling to exert this function. In vivo, intraarticular injection of lentiviral Wnt7a strongly attenuated articular cartilage damage induced by destabilization of the medial meniscus (DMM) OA-inducing surgery in mice. Consistently, Wnt7a also inhibited the progressive increase of joint MMP activity in DMM animals. These results indicate that Wnt7a signaling inhibits inflammatory stimuli-induced catabolic gene expression in human articular chondrocytes and is sufficient to attenuate MMP activities and promote joint cartilage integrity in mouse experimental OA, demonstrating a novel effect of Wnt7a on regulating OA pathogenesis.

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Reduction in the cost of health care claims among hypertensive employees was examined over a 4-year period after exposure to a 3-year blood pressure control program, to see whether work-site monitoring and counseling produced a subsequent benefit. Hypertensive employees at three experimental sites (N = 183 to 367 subjects) were compared with subjects at a control site (N = 169) who had received no postscreening follow-up or monitoring, and with matched normotensive employees. The cost of subsequent health care claims for hypertensive employees at the experimental sites was lower than claims for those at the control site, but there was no significant difference across the sites in claims for normotensive employees. After adjusting to a standard 1982 dollar, the data showed from $1.89 to $2.72 in reduced health care claims per dollar spent operating the hypertension control program.